A patient with bleeding esophageal varices is scheduled to receive a bolus followed by a continuous infusion of octreotide (Sandostatin). The nurse preparing the medication would:
1. Anticipate that the medication will stop the bleeding immediately.
2. Notify the physician if the patient has cardiac disease because the medication is contraindicated.
3. Recognize that doses of 100 mcg/hour and higher are associated with better outcomes.
4. Review serial hematocrit levels to determine if the patient is continuing to bleed.
4
Rationale 1: This medication is effective in temporarily stopping the bleeding in approximately 80% of patients.
Rationale 2: Octreotide (Sandostatin) has an excellent safety margin and is safe for patients with cardiac disease.
Rationale 3: Doses greater than 50 mcg/hr may increase systemic venous pressure and do not increase the portal hypotensive effects.
Rationale 4: To evaluate response to the octreotide (Sandostatin) infusion, the nurse would continue to monitor the patient's hemodynamic status and expect to see the patient's vital signs return to normal, urine output increase, and a decrease in overt bleeding: hematemesis, melena, and hematochezia. Serial hematocrit levels should be evaluated.
You might also like to view...
The nurse discussing foot care with an elderly patient with diabetes realizes that the information she is teaching is extremely important because:
A) An elderly patient with foot ulcers experiences severe foot pain due to diabetic polyneuropathy. B) Avoiding the complications associated with foot ulcers may mean the difference between institutionalization and continued independent living. C) Hypoglycemia is a dangerous situation and it may lead to unsteadiness of the feet and falls. D) Drugs that the patients are required to take for their diabetes often decrease circulation to the lower extremities.
A client is being discharged from the hospital on warfarin for atrial fibrillation. The client asks the nurse, "What can I use if I have a headache?" The nurse responds by telling the client that which of the following would be appropriate to use?
A) Bufferin B) Tylenol C) Ecotrin D) Empirin
A pregnant woman tells you that she does not drink much fluid daily. How many glasses of fluid would you advise her to ingest daily during pregnancy?
A) 2 B) 4 C) 6 D) 10
A patient recovering from thyroid surgery is now experiencing numbness and tingling around the mouth with an increase in irritability. Which additional assessment finding would cause the nurse the most concern?
1. Decreased creatinine and BUN levels 2. Abdominal distention and pain 3. Hyperactive bowel sounds 4. Diarrhea